Long‐term results of prolapse recurrence and functional outcome after vaginal hysterectomy

To evaluate the incidence of prolapse and prolapse‐related symptoms following vaginal hysterectomy.

Data were reviewed from women who underwent vaginal hysterectomy between 1988, and 1995, at St George's Hospital, London, UK, and attended long‐term follow‐up. Outcome measures included a questionnaire for prolapse, urinary, bowel, and sexual symptoms; and a vaginal examination.

Among 94 women attending long‐term evaluation, the mean follow‐up time was 100.7 months (range 67.0–156.0 months). Before vaginal hysterectomy, urgency was noted among 23 (24.5%), urge incontinence among 11 (11.7%), and stress incontinence among 8 (8.5%) women. At follow‐up, these symptoms were observed among 23 (24.5%), 13 (13.8%), and 6 (6.4%) women, respectively. De novo urge incontinence and de novo stress incontinence were observed among 3 (3.2%) and 2 (2.1%) women, respectively. Vaginal examination data were compared for 70 women, of whom 18 (25.7%) had grade 1, 40 (57.1%) had grade 2, and 6 (8.6%) had grade 3 uterine prolapsed before surgery. Postoperatively, vaginal vault prolapse occurred in 7 (10.0%) women and correlated with degree of posterior prolapse (P = 0.007), but not with severity of uterine descent (P = 0.205) or previous prolapse surgery (P = 0.573).

The incidence of post‐hysterectomy vault prolapse correlated with the degree of preoperative rectocele.